MEDICARE: DR. DARCIE KUNDER VMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174M00000X	Veterinarian	6383-50	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	6383-50	OTHER	WI	WISCONSIN VETERINARY LICENSE

General Provider Information

NPI Number	:	1639424625
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DARCIE KUNDER VMD

Provider Business Mailing Address
First Line	:	3900 DELANCEY ST
Second Line	:	RYAN VETERINARY HOSPITAL
City	:	PHILADELPHIA
State	:	PA
Zip	:	19104-5052
Country	:	US
Telephone Number	:	215-898-8861
Fax Number	:

Provider Business Practice Location Address
First Line	:	3900 DELANCEY ST
Second Line	:	RYAN VETERINARY HOSPITAL
City	:	PHILADELPHIA
State	:	PA
Zip	:	19104-5052
Country	:	US
Telephone Number	:	215-898-8861
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/17/2012
Last Update Date	:	07/17/2012

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